By Adebowale Bello. B.Tech Microbiology, Freelance Health Writer and Akintola Odutola, B. Med Sci., MB., BS., Ph.D., FRCSEd. (Chair and Editorial Team Leader, Datelinehealth Africa, Inc.)
In many African countries, the journey to becoming a doctor typically spans six or seven years of higher education. While comprehensive, this traditional approach has contributed to a slow-growing doctor workforce leading to shortages in several communities.
With a growing population and limited resources, the demand for skilled healthcare workers continues to rise. It may be time for policymakers and leaders in the African medical space to consider whether a shorter, high-quality training program could be adapted to the continent's needs.
One potential solution gaining attention is accelerated medical training; a concept increasingly adopted in other parts of the world. These accelerated programs shave a year or so from the traditional training period, without evidence of loss in quality of training, according to a recent study. Could such a model work in African medical schools?
A study comparing accelerated medical programs to traditional ones in the United States focused on post-baccalaureate students who graduated from accelerated three-year medical programs across nine schools and compared their responses to those from traditional four-year programs.
The research revealed the following key findings that can inform Africa’s potential to adapt the program strategies.
The study found that graduates from accelerated programs reported similar levels of satisfaction with their education as their peers in traditional programs. Importantly, they also felt just as prepared for residency suggesting that, with careful curriculum planning, a shorter timeline can still provide the essential skills and competencies needed for clinical practice.
Accelerated students reported a positive learning climate, particularly in terms of student-faculty interaction and emotional support. Surprisingly, they did not report increased levels of burnout, dispelling concerns that a shorter program might overburden students.
Debt remains a significant issue for medical students worldwide. Shortened programs means lower tuition and graduates can enter the workforce sooner with lower debt. In Africa, where the financial barrier to medical education is substantial, this could be a game-changer for prospective students from low- and middle-income families.
In accelerated programs, students exhibited a stronger commitment to serving in rural communities. Given that Africa’s rural regions face chronic shortage of doctors, graduates from shorter programs could be encouraged or incentivized to serve in these areas.
While the findings from the study may have limitations due to self-reporting bias, it may still be appropriate and worthy for African medical education leaders to consider pilot programs that reduce the duration of medical training.
Below are some potential advantages, as well as key factors to keep in mind.
The need for more doctors in Africa is undeniable. According to the World Health Organization (WHO), many African countries have way less than 1 doctor per 1,000 people compared to the world average of approximately 2 per 1,000 people served. By adopting an accelerated training model, African medical schools could increase their annual graduate output, steadily strengthening the physician pipeline.
A reduction in the traditional six-year program by one or two years, leading to an accelerated yet rigorous curriculum allows institutions to graduate doctors in less time without sacrificing quality. These shorter programs could also attract more students, thereby broadening the base of trained professionals available for deployment across regions.
The cost of training for students, institutions and governments, is a significant barrier in Africa. By shortening the medical education timeline, students would incur lower tuition fees and reduced opportunity cost associated with prolonged education. Institutions could potentially allocate resources more efficiently, increasing their intake capacity and support a larger number of students over time.
With a well-structured curriculum and an emphasis on essential competencies, African schools could feasibly adopt similar quality models, improving accessibility to medical education for those from economically disadvantaged backgrounds.
Any pilot program in Africa should take into account the unique needs of each African country’s health systems. These programs should prioritize skills and knowledge directly applicable to prevalent health challenges within Africa. Hence, rural and community health training should be emphasized, ensuring graduates are well-prepared to serve in these areas upon completion.
While the benefits are clear, there are also valid concerns about accelerated programs, especially regarding clinical experience.
The pace of learning may limit the depth of hands-on training, which is essential for medical competence. Therefore, any implementation in Africa would require careful curriculum design to balance comprehensive clinical exposure with a condensed theoretical study period.
One proposal to address this clinical competency exposure and training concern may be to extend supervised paid Internship for graduates of accelerated programs by 6 months to a year relative to graduates of traditional programs.
There may also be concerns about an increased risk of burnout among students. However, these issues can be mitigated by strategically designing the curriculum to focus on high-impact areas, integrating early clinical exposure, and supporting students through mentorship and robust mental health resources.
To determine the viability of a shortened training period, African medical education leaders can consider establishing pilot programs in select institutions. A phased approach, with careful monitoring and evaluation, would allow for evidence-based conclusions about the impact of such a shift on educational quality and workforce readiness.
The implementation plan could be structured as follows:
Accelerated medical training offers an innovative solution toward addressing Africa’s healthcare worker shortage and the economic barriers to medical education. By shortening the length of education without sacrificing quality, African medical schools could potentially produce more doctors in less time, helping address the shortage of healthcare workers.
Policymakers, educators and medical institutions must collaborate to ensure that accelerated programs meet the continent’s healthcare needs. With careful planning and local adaptation, accelerated medical training could become a transformative model in Africa’s medical education landscape.
Satyamoorthi N, Marine M, Ludlow P, Triola M, Gillespie C, Cohen E, Abramson S, Cangiarella J. Outcomes of Accelerated 3-Year MD Graduates at NYU Grossman School of Medicine During Medical School and Early Residency. Academic Medicine. October 15, 2024. Available from here.
Leong S.L, Gillespie C, Jones B, Fancher T, Coe C.L, Dodson L, Hunsaker M, Thompson B.M, Dempsey A, Pallay R, Crump W, Cangiarella J. Accelerated 3-Year MD Pathway Programs: Graduates’ Perspectives on Education Quality, the Learning Environment, Residency Readiness, Debt, Burnout, and Career Plans. Academic Medicine. February 2022. Available from here.
Published: November 14, 2024
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